Supporting HIV prevention and reproductive goals in an HIV-endemic setting: taking safer conception services from policy to practice in South Africa.
Identifieur interne : 000729 ( PubMed/Curation ); précédent : 000728; suivant : 000730Supporting HIV prevention and reproductive goals in an HIV-endemic setting: taking safer conception services from policy to practice in South Africa.
Auteurs : Natasha E C G. Davies [Afrique du Sud] ; Lynn T. Matthews [États-Unis] ; Tamaryn L. Crankshaw [Afrique du Sud] ; Di Cooper [Afrique du Sud] ; Sheree R. Schwartz [Afrique du Sud]Source :
- Journal of the International AIDS Society [ 1758-2652 ] ; 2017.
Descripteurs français
- KwdFr :
- MESH :
English descriptors
- KwdEn :
- MESH :
- epidemiology : HIV Infections.
- prevention & control : HIV Infections, Infectious Disease Transmission, Vertical.
- Endemic Diseases, Female, Fertilization, Goals, Humans, Male, Reproductive Health Services, Sexual Partners, South Africa.
Abstract
Safer conception care encompasses HIV care, treatment and prevention for persons living with HIV and their partners who desire children. In 2012, South Africa endorsed a progressive safer conception policy supporting HIV-affected persons to safely meet reproductive goals. However, aside from select research-supported clinics, widespread implementation has not occurred. Using South Africa as a case study, we identify key obstacles to policy implementation and offer recommendations to catalyse expansion of these services throughout South Africa and further afield.
DOI: 10.7448/IAS.20.2.21271
PubMed: 28361506
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Davies</name><affiliation wicri:level="1"><nlm:affiliation>Wits Reproductive Health and HIV Institute, University of the Witwatersrand, Johannesburg, South Africa.</nlm:affiliation><country xml:lang="fr">Afrique du Sud</country><wicri:regionArea>Wits Reproductive Health and HIV Institute, University of the Witwatersrand, Johannesburg</wicri:regionArea></affiliation></author><author><name sortKey="Matthews, Lynn T" sort="Matthews, Lynn T" uniqKey="Matthews L" first="Lynn T" last="Matthews">Lynn T. 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Crankshaw</name><affiliation wicri:level="1"><nlm:affiliation>Health Economics and HIV and AIDS Research Division (HEARD), University of KwaZulu-Natal, Durban, South Africa.</nlm:affiliation><country xml:lang="fr">Afrique du Sud</country><wicri:regionArea>Health Economics and HIV and AIDS Research Division (HEARD), University of KwaZulu-Natal, Durban</wicri:regionArea></affiliation></author><author><name sortKey="Cooper, Di" sort="Cooper, Di" uniqKey="Cooper D" first="Di" last="Cooper">Di Cooper</name><affiliation wicri:level="1"><nlm:affiliation>School of Public Health, University of the Western Cape, Cape Town, South Africa.</nlm:affiliation><country xml:lang="fr">Afrique du Sud</country><wicri:regionArea>School of Public Health, University of the Western Cape, Cape Town</wicri:regionArea></affiliation></author><author><name sortKey="Schwartz, Sheree R" sort="Schwartz, Sheree R" uniqKey="Schwartz S" first="Sheree R" last="Schwartz">Sheree R. Schwartz</name><affiliation wicri:level="1"><nlm:affiliation>Wits Reproductive Health and HIV Institute, University of the Witwatersrand, Johannesburg, South Africa.</nlm:affiliation><country xml:lang="fr">Afrique du Sud</country><wicri:regionArea>Wits Reproductive Health and HIV Institute, University of the Witwatersrand, Johannesburg</wicri:regionArea></affiliation></author></analytic><series><title level="j">Journal of the International AIDS Society</title><idno type="eISSN">1758-2652</idno><imprint><date when="2017" type="published">2017</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Endemic Diseases</term><term>Female</term><term>Fertilization</term><term>Goals</term><term>HIV Infections (epidemiology)</term><term>HIV Infections (prevention & control)</term><term>Humans</term><term>Infectious Disease Transmission, Vertical (prevention & control)</term><term>Male</term><term>Reproductive Health Services</term><term>Sexual Partners</term><term>South Africa</term></keywords><keywords scheme="KwdFr" xml:lang="fr"><term>Femelle</term><term>Fécondation</term><term>Humains</term><term>Infections à VIH ()</term><term>Infections à VIH (épidémiologie)</term><term>Maladies endémiques</term><term>Mâle</term><term>Objectifs</term><term>Partenaire sexuel</term><term>République d'Afrique du Sud</term><term>Services de santé génésique</term><term>Transmission verticale de maladie infectieuse ()</term></keywords><keywords scheme="MESH" qualifier="epidemiology" xml:lang="en"><term>HIV Infections</term></keywords><keywords scheme="MESH" qualifier="prevention & control" xml:lang="en"><term>HIV Infections</term><term>Infectious Disease Transmission, Vertical</term></keywords><keywords scheme="MESH" qualifier="épidémiologie" xml:lang="fr"><term>Infections à VIH</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Endemic Diseases</term><term>Female</term><term>Fertilization</term><term>Goals</term><term>Humans</term><term>Male</term><term>Reproductive Health Services</term><term>Sexual Partners</term><term>South Africa</term></keywords><keywords scheme="MESH" xml:lang="fr"><term>Femelle</term><term>Fécondation</term><term>Humains</term><term>Infections à VIH</term><term>Maladies endémiques</term><term>Mâle</term><term>Objectifs</term><term>Partenaire sexuel</term><term>République d'Afrique du Sud</term><term>Services de santé génésique</term><term>Transmission verticale de maladie infectieuse</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Safer conception care encompasses HIV care, treatment and prevention for persons living with HIV and their partners who desire children. In 2012, South Africa endorsed a progressive safer conception policy supporting HIV-affected persons to safely meet reproductive goals. However, aside from select research-supported clinics, widespread implementation has not occurred. Using South Africa as a case study, we identify key obstacles to policy implementation and offer recommendations to catalyse expansion of these services throughout South Africa and further afield.</div></front></TEI><pubmed><MedlineCitation Status="MEDLINE" Owner="NLM"><PMID Version="1">28361506</PMID><DateCreated><Year>2017</Year><Month>03</Month><Day>31</Day></DateCreated><DateCompleted><Year>2017</Year><Month>09</Month><Day>13</Day></DateCompleted><DateRevised><Year>2017</Year><Month>09</Month><Day>28</Day></DateRevised><Article PubModel="Print"><Journal><ISSN IssnType="Electronic">1758-2652</ISSN><JournalIssue CitedMedium="Internet"><Volume>20</Volume><Issue>Suppl 1</Issue><PubDate><Year>2017</Year><Month>03</Month><Day>08</Day></PubDate></JournalIssue><Title>Journal of the International AIDS Society</Title><ISOAbbreviation>J Int AIDS Soc</ISOAbbreviation></Journal><ArticleTitle>Supporting HIV prevention and reproductive goals in an HIV-endemic setting: taking safer conception services from policy to practice in South Africa.</ArticleTitle><Pagination><MedlinePgn>21271</MedlinePgn></Pagination><ELocationID EIdType="doi" ValidYN="Y">10.7448/IAS.20.2.21271</ELocationID><Abstract><AbstractText Label="INTRODUCTION">Safer conception care encompasses HIV care, treatment and prevention for persons living with HIV and their partners who desire children. In 2012, South Africa endorsed a progressive safer conception policy supporting HIV-affected persons to safely meet reproductive goals. However, aside from select research-supported clinics, widespread implementation has not occurred. Using South Africa as a case study, we identify key obstacles to policy implementation and offer recommendations to catalyse expansion of these services throughout South Africa and further afield.</AbstractText><AbstractText Label="DISCUSSION">Four key implementation barriers were identified by combining authors' safer conception service delivery experiences with available literature. First, strategic implementation frameworks stipulating where, and by whom, safer conception services should be provided are needed. Integrating safer conception services into universal test-and-treat (UTT) and elimination-of-mother-to-child-transmission (eMTCT) priority programmes would support HIV testing, ART initiation and management, viral suppression and early antenatal/eMTCT care engagement goals, reducing horizontal and vertical transmissions. Embedding measurable safer conception targets into these priority programmes would ensure accountability for implementation progress. Second, facing an organizational clinic culture that often undermines clients' reproductive rights, healthcare providers' (HCP) positive experiences with eMTCT and enthusiasm for UTT provide opportunities to shift facility-level and individual attitudes in favour of safer conception provision. Third, safer conception guidelines have not been incorporated into HCP training. Combining safer conception with "test-and-treat" training would efficiently ensure that providers are better equipped to discuss clients' reproductive goals and support safer conception practices. Lastly, HIV-affected couples remain largely unaware of safer conception strategies. HIV-affected populations need to be mobilized to engage with safer conception options alongside other HIV-related healthcare services.</AbstractText><AbstractText Label="CONCLUSION">Key barriers to widespread safer conception service provision in South Africa include poor translation of policy into practical and measurable implementation plans, inadequate training and limited community engagement. South Africa should leverage the momentum and accountability associated with high priority UTT and eMTCT programmes to reinvigorate implementation efforts by incorporating safer conception into implementation and monitoring frameworks and associated HCP training and community engagement activities. South Africa's experiences should be used to inform policy development and implementation processes in other HIV high-burden countries.</AbstractText></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Davies</LastName><ForeName>Natasha E C G</ForeName><Initials>NE</Initials><AffiliationInfo><Affiliation>Wits Reproductive Health and HIV Institute, University of the Witwatersrand, Johannesburg, South Africa.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Matthews</LastName><ForeName>Lynn T</ForeName><Initials>LT</Initials><AffiliationInfo><Affiliation>Massachusetts General Hospital, Global Health, Division of Infectious Disease, Boston, MA, USA.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Crankshaw</LastName><ForeName>Tamaryn L</ForeName><Initials>TL</Initials><AffiliationInfo><Affiliation>Health Economics and HIV and AIDS Research Division (HEARD), University of KwaZulu-Natal, Durban, South Africa.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Cooper</LastName><ForeName>Di</ForeName><Initials>D</Initials><AffiliationInfo><Affiliation>School of Public Health, University of the Western Cape, Cape Town, South Africa.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Schwartz</LastName><ForeName>Sheree R</ForeName><Initials>SR</Initials><AffiliationInfo><Affiliation>Wits Reproductive Health and HIV Institute, University of the Witwatersrand, Johannesburg, South Africa.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.</Affiliation></AffiliationInfo></Author></AuthorList><Language>eng</Language><GrantList CompleteYN="Y"><Grant><GrantID>P30 AI094189</GrantID><Acronym>AI</Acronym><Agency>NIAID NIH HHS</Agency><Country>United States</Country></Grant><Grant><GrantID>K23 MH095655</GrantID><Agency>U.S. National Institutes of Health</Agency><Country>International</Country></Grant><Grant><GrantID>P30AI094189</GrantID><Agency>U.S. National Institutes of Health</Agency><Country>International</Country></Grant></GrantList><PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType></PublicationTypeList></Article><MedlineJournalInfo><Country>Switzerland</Country><MedlineTA>J Int AIDS Soc</MedlineTA><NlmUniqueID>101478566</NlmUniqueID><ISSNLinking>1758-2652</ISSNLinking></MedlineJournalInfo><CitationSubset>IM</CitationSubset><CitationSubset>X</CitationSubset><CommentsCorrectionsList><CommentsCorrections RefType="Cites"><RefSource>Front Public Health. 2016 May 17;4:95</RefSource><PMID Version="1">27242987</PMID></CommentsCorrections><CommentsCorrections RefType="Cites"><RefSource>AIDS Behav. 2009 Jun;13 Suppl 1:38-46</RefSource><PMID Version="1">19343492</PMID></CommentsCorrections><CommentsCorrections RefType="Cites"><RefSource>Philos Ethics Humanit Med. 2010 Jul 09;5:11</RefSource><PMID 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MajorTopicYN="N">Humans</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D018445" MajorTopicYN="N">Infectious Disease Transmission, Vertical</DescriptorName><QualifierName UI="Q000517" MajorTopicYN="N">prevention & control</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D008297" MajorTopicYN="N">Male</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D034121" MajorTopicYN="Y">Reproductive Health Services</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D012747" MajorTopicYN="N">Sexual Partners</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D013019" MajorTopicYN="N">South Africa</DescriptorName></MeshHeading></MeshHeadingList><KeywordList Owner="NOTNLM"><Keyword MajorTopicYN="Y">HIV prevention</Keyword><Keyword MajorTopicYN="Y">HIV treatment</Keyword><Keyword MajorTopicYN="Y">South Africa</Keyword><Keyword MajorTopicYN="Y">reproductive rights</Keyword><Keyword MajorTopicYN="Y">safer conception</Keyword></KeywordList><CoiStatement>None of the authors have any competing interests to declare.</CoiStatement></MedlineCitation><PubmedData><History><PubMedPubDate PubStatus="entrez"><Year>2017</Year><Month>4</Month><Day>1</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="pubmed"><Year>2017</Year><Month>4</Month><Day>1</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="medline"><Year>2017</Year><Month>9</Month><Day>14</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate></History><PublicationStatus>ppublish</PublicationStatus><ArticleIdList><ArticleId IdType="pubmed">28361506</ArticleId><ArticleId IdType="doi">10.7448/IAS.20.2.21271</ArticleId><ArticleId IdType="pmc">PMC5577693</ArticleId></ArticleIdList></PubmedData></pubmed></record>Pour manipuler ce document sous Unix (Dilib)
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